Busy. Please wait.

show password
Forgot Password?

Don't have an account?  Sign up 

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove ads
Don't know
remaining cards
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

108 Unit 1


Methods -Percutaneous Stick -Arterial Line -Umbilical catheter -Capillary
Indications -Evaluate the Adequacy of Acid-base (pH, PaCO2, and HCO3), Ventilation (paCO2), and oxygenation (PaO2, and O2Hb) -Determine the response to therapeutic intervention -Monitor Severity and Progression of a disease process
Therapeutic Interventions -Supplemental Oxygen -Mechanical Ventilation -Diagnostic Evaluation (exercise desaturation)
Contraindications for ABG -Negative modified Allen Test -Arteriovenous shunt (dialysis patient) -Improperly functional gas analyzer -Specimen not properly anticoagulated -Visible air bubbles -Incomplete requisition (interpretation and documentation) -unlabeled specimen
Hazards of ABG Puncture -Infection of technician (needlestick) -Inappropriate medical treatment -Vessel spasm -Hematoma -Laceration of the artery -Hemorrhage -Vasovagal reaction -Loss of Limb
Equipment and Supplies -ABG syring (3-5 cc pre-heparinized) -Needle (1-1.5 inch, 22 gauge) -Needle protection device -alcohol -gauze -band-aid -gloves -rubber stopper -biohazard bag -ice container
Glass Syringe -Not gas permeable -results remain stable -if analysis cannot be performed in 30 minutes -place in ice/water slush to prevent metabolism changes -can remain stable iced for up to 2 hours
Plastic Syringe -gas permeable -most common -don't ice -results main stable for 30 minutes
Heparin prevents blood sample from clotting
Lithium Heparin -lypholized (dry) -used if running electrolyte panels -premeasured amounts for preventing dilution of samples -white dot
Sodium Heparin -usually in solution -can affect pH result -affects the electrolyte panels -used primarily with arterial lines
Adult Site Selection Sites -Radial (site of choice) -Brachial -Femoral -Popliteal -Dorsalis Pedis
Pediatric Site Selection -Radial -Brachial -Capillary
Neonates/Newborn Site Selection -Umbilical -Radial -Capillary
How long should it take for color to return in a Modified Allen's Test? 10 seconds
What do you palpate to determine? -size -direction -depth
What do you clean the site with? -alcohol -betadine
Which angle is the needle inserted at? -30-45 degree angle
How long should you apply pressure over the puncture site in normal individuals? 5 minutes
How long should you apply pressure over the puncture site in individuals on anticoagulants? 10-15 minutes
How do you mix the specimen? -inversion or rotation
Labeling Information -Date and Time -Name -FMP/SSN -Puncture sites -FIO2 or O2 liter flow -ventilator setting -Patient Temperature -Technician Name -Ordering Physician
Brachial Artery -Major artery of the upper arm -divides into radial and ulnar just below the elbow
Indication for Sticking the Brachial Artery -The radial arteries are unsuitable -Negative Allen Test
Hazards of Sticking the Brachial Artery -Deeper Vessel -Harder to stabilize -More susceptible to hematoma -Median nerve damage -No collateral circulation
Where do you palpate on for the Brachial Artery? -antecubital fossa
Where do you follow the arterial pulse on the brachial artery? -2-3 cm Proximally
What angle do you use for the Brachial artery? -45 degree angle
When must a sample be analyzed immediately regardless of syringe? -paO2 > 150 mmHg
Sampling Errors (Pre-analytic) -Air bubbles (most common) -delay in analysis -Improper Mixing (heparin unmixed) -Improper syringe -Venous Sample -Improper anticoagulant (sodium heparin) -Too little heparin (clots in machine) -Too much heparin (dilutes sample)
Gas Tensions in the Air (Bubble) -O2: 150 mmHg -CO2: essentially zero -N2 - inert
Gas Tensions in Arterial Blood -O2: normal 80-100 mmHg -CO2: normal 35-45
CO2 effect -CO2 diffuses out of the blood into the sample decreasing the PaCO2 -increases the pH of the sample
O2 effect -normally O2 in the bubble has a higher tension than the sample so O2 wil diffuse out of the bubble into the sample -increases measured PaO2
Hyperoxygenated patient 500-600 mmHg -paO2 will decrease due to diffusion
Capillary Sampling -an arterial blood gas sampling in infants -correlates wtih PacO2 and pH -does not correlate well with PaO2
Indications for Capillary Sampling -ABG analysis is needed but arterial access is not available -May only need to look at ventilation -Non-invasisve monitors are inaccurate or abnormal
Contraindications for Capillary Sampling -not performed at the certain sites -patients less than 24 years old -When there is a need for accurate analysis of oxygenation
Sites NOT to be used for Capillary Sampling -posterior curvature of the heel -fingers of neonates -previous puncture sites -swollen or edematous tissue -cyanotic poorly perfused tissue -areas of infection -peripheral arteries
Hazards of Capillary Sampling -infection -burns -hematoma -nerve damage -pain -bleeding
Equipment -gloves -pre-heparinized glass capillary tube -metal flea and magnet (for mixing sample) -lancet -gauze -warming pack/moist warm diaper -band-aid -alcohol pad
What is the heat limit for capillary sampling? -not higher than 42 degrees celsius
What is the puncture limit for capillary sampling? -not deeper than 2.0 mm
What must you not do at the site for capillary sampling? -do not squeeze the site to increase blood flow -results in excess amounts of serous fluid and venous contamination of the sample
Created by: Mdarrielle09